Background: Changes in physical activity (PA) after implantable cardioverter defibrillator (ICD) or cardiac resynchronization therapy defibrillators (CRT-D) implantation were unknown. The association of PA changes with new-onset atrial fibrillation (AF), cardiac death and all-cause mortality was unclear in patients at high risk of sudden cardiac death. Methods: Patients receiving ICD/CRT-D implantation from SUMMIT registry were retrospectively analyzed. Changes in PA were considered from baseline status to 1 year after implantation. New-onset AF was defined as the first atrial high-rate episode ≥1% of the daily AF burden detected after implantation. Results: Over a mean follow-up of 50.3 months, 124 new-onset AF events (36.2%), 61 cardiac deaths (17.8%), and 87 all-cause deaths (25.4%) were observed in 343 patients with ICD/CRT-D implantation. PA at 1 year after implantation was increased compared with PA at baseline (11.97 ± 5.83% vs. 10.82 ± 5.43%, P = 0.008), and PA at 1 year was improved in 210 patients (61.2%). Per 1% decrease in PA was associated with 12.4, 18.3, and 14.3% higher risks of new-onset AF, cardiac death and all-cause mortality, regardless of different baseline characteristics. Patients with decreased PA had 2-fold risks of new-onset AF (hazard ratio [HR] = 1.972, 95% confidence interval [CI]: 1.352-2.877, P < 0.001) as high as those with unchanged/increased PA. Decreased PA was an independent risk factor for cardiac death (HR = 3.358, 95% CI: 1.880-5.996, P < 0.001) and all-cause mortality (HR = 2.803, 95% CI:1.732-4.535, P < 0.001). Conclusion: PA decrease after ICD/CRT-D implantation is associated with a higher incidence of new-onset AF, resulting in worsened outcomes in cardiac death and all-cause mortality.

中文翻译：

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ICD/CRT-D 植入后体力活动变化与新发房颤之间的关联。

背景：植入式心脏复律除颤器 (ICD) 或心脏再同步治疗除颤器 (CRT-D) 植入后体力活动 (PA) 的变化尚不清楚。在心源性猝死高危患者中，PA 变化与新发心房颤动 (AF)、心源性死亡和全因死亡率的关联尚不清楚。方法：对 SUMMIT 注册中心接受 ICD/CRT-D 植入的患者进行回顾性分析。考虑从基线状态到植入后 1 年的 PA 变化。新发 AF 定义为植入后检测到的≥1% 的每日 AF 负荷的第一次心房高频率发作。结果：在平均 50.3 个月的随访期间，在 343 名 ICD/CRT 患者中观察到 124 例新发 AF 事件（36.2%）、61 例心脏死亡（17.8%）和 87 例全因死亡（25.4%） -D 植入。植入后 1 年的 PA 与基线时的 PA 相比有所增加（11.97 ± 5.83% 与 10.82 ± 5.43%，P = 0.008），210 名患者（61.2%）在 1 年时的 PA 有所改善。无论基线特征如何，PA 每减少 1%，新发房颤、心脏死亡和全因死亡率的风险就会增加 12.4%、18.3% 和 14.3%。PA 降低的患者新发 AF 的风险是 PA 不变/增加的患者的 2 倍（风险比 [HR] = 1.972，95% 置信区间 [CI]：1.352-2.877，P < 0.001）。PA 降低是心脏死亡（HR = 3.358，95% CI：1.880-5.996，P < 0.001）和全因死亡率（HR = 2.803，95% CI：1.732-4.535，P < 0.001）的独立危险因素。结论：ICD/CRT-D 植入后 PA 降低与新发 AF 的发生率较高有关，